K76.5 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupK76.5

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Diseases of liver (K70-K77)

K76.5

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Hepatic veno-occlusive disease

A condition where the small veins within the liver become blocked, leading to increased pressure and potential liver failure.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

K76Other diseases of liver K76.5Hepatic veno-occlusive disease

Inclusion Terms

Official

No inclusion terms are included in this display for K76.5. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from K00-K95, K70-K77, K76
certain infectious and parasitic diseases (A00-B99)Inherited from K00-K95, K70-K77, K76
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from K00-K95, K70-K77, K76
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from K00-K95, K70-K77, K76
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from K00-K95, K70-K77, K76
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from K00-K95, K70-K77, K76
neoplasms (C00-D49)Inherited from K00-K95, K70-K77, K76
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from K00-K95, K70-K77, K76
hemochromatosis (E83.11-)Inherited from K00-K95, K70-K77, K76
Reye's syndrome (G93.7)Inherited from K00-K95, K70-K77, K76
viral hepatitis (B15-B19)Inherited from K00-K95, K70-K77, K76
Wilson's disease (E83.01)Inherited from K00-K95, K70-K77, K76
alcoholic liver disease (K70.-)Inherited from K00-K95, K70-K77, K76
amyloid degeneration of liver (E85.-)Inherited from K00-K95, K70-K77, K76
cystic disease of liver (congenital) (Q44.6)Inherited from K00-K95, K70-K77, K76
hepatic vein thrombosis (I82.0)Inherited from K00-K95, K70-K77, K76
hepatomegaly NOS (R16.0)Inherited from K00-K95, K70-K77, K76
pigmentary cirrhosis (of liver) (E83.110)Inherited from K00-K95, K70-K77, K76
portal vein thrombosis (I81)Inherited from K00-K95, K70-K77, K76
toxic liver disease (K71.-)Inherited from K00-K95, K70-K77, K76

Related Codes

Official

K76.0Fatty (change of) liver, not elsewhere classified K76.1Chronic passive congestion of liver K76.2Central hemorrhagic necrosis of liver K76.3Infarction of liver K76.4Peliosis hepatis

Includes

Official

No Includes notes are included in this display for K76.5. Check the code and parent instructions in the Code Book.

Excludes 1

Official

Budd-Chiari syndrome (I82.0)
jaundice NOS (R17)Inherited from K70-K77

Code First

Official

No Code First sequencing instructions are included in this display for K76.5. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for K76.5. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for K76.5. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Often associated with chemotherapy, radiation, or stem cell transplantation; document the underlying cause

Code any resulting complications such as ascites or portal hypertension separately if applicable

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is K76.5 an HCC code?

No. K76.5 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: K76.5
Description: Hepatic veno-occlusive disease
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

K76.5 is the ICD-10-CM diagnosis code for hepatic veno-occlusive disease. A condition where the small veins within the liver become blocked, leading to increased pressure and potential liver failure. K76.5 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of liver (k70-k77).

K76.5 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Often associated with chemotherapy, radiation, or stem cell transplantation; document the underlying cause.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for K76.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Often associated with chemotherapy, radiation, or stem cell transplantation; document the underlying cause
•Code any resulting complications such as ascites or portal hypertension separately if applicable